This transcript has been edited for readability.
Faces of the Epidemic:
Bernstein: Good morning, everyone. I’m Lenny Bernstein. I’m a health and medicine reporter here at The Washington Post. I am going to introduce to you today Todd and Dorie Burke. They’re the parents of Thad Burke, who was one of the estimated 62,000 people who died of a drug overdose in 2016. And Alice Li, the Washington Post video journalist who made that remarkable video that you just saw. [APPLAUSE] Todd and Dorie, can you tell us a little bit about how Thad’s addiction began, Thad’s painkiller addiction began and how it progressed?
Burke: Well, in January of 2015 he had an injury, broke his hand and foot. And we took him to the emergency room and everything. And, you know, he got prescribed painkillers. And we had no idea that he got addicted to painkillers. Now in around October of 2015 his mom found Suboxone in his room. And of course I was upset. I yelled at him. I said, “Thad, this is what inmates try to have sent into the prison system.” And then that’s when he told us about his addiction to painkillers. And I looked it up online, educated myself a little bit about it, and then I went back upstairs to the top of the steps and yelled over to Thad. I told him, “Thad, I’m sorry. I love you.”
Bernstein: He was on Suboxone in an attempt to beat his painkiller addiction?
Burke: Yeah. I said, “Thad, I love you. If anything ever happened to you, I wouldn’t want to live.” And then of course we had him in rehab two different times at Marworth. And the first time he went through rehab he was doing real good, was real excited, wanted to get clean and wanted to be good, and was really good about going to meetings and everything. But first time he went to rehab he was able to get Vivitrol, the blocker.
Bernstein: It’s a long-acting blocker.
Burke: But then it only lasts for like 30 days or so. And I called around to different places, couldn’t find any place to subscribe him that. And I called a place in Milton, but they only prescribed to patients that went through treatment at White Deer Treatment Center, so I wasn’t able to get him the thing. And then eventually he relapsed.
Bernstein: Dorie, relapse is common. When Thad came out of rehab were you hopeful? What did you think might happen?
Burke: Well, I thought this was just a bump in the road, because he really wanted to get batter and he just—I mean, it was just totally out of our family, our realm of like—I’m just going to say it. It just doesn’t happen to us.
Bernstein: And when he did relapse what clues did you have? What did you see?
Burke: Just some behaviors that I just said, “You know, you’re reminding me of when.” And he’s like, “No, no, no, no.”
Bernstein: When he relapsed was he back to using pain pills or was he using street drugs or what finally turned out to happen?
Burke: When he didn’t have pain pills or Suboxone that’s when he turned to heroin. Now, he relapsed, so we took him back again to Marworth. And then he didn’t do as good when he came home as he did the first time. He wasn’t as excited. He had drug court coming up and had all the anxiety and everything. And then like about three days before he would have had drug court—I think drug court would have been real good for him because it would have held him accountable, would have been structured; he would have had structure in his life because he would have to go to so many meetings, so many self-help groups, you know, and be held accountable.
But three days before he would have had drug court is when I woke up to my wife screaming in the morning, “Thad, wake up. Thad, wake up.” And I went over—you know, as soon as that happened it’s like I knew what was going on in my head. I jumped out of bed. I grabbed the phone and dialed 911, ran to my son’s room. And he was not breathing, and he was blue, lying on the bed. And I had the phone in one hand and I grabbed him, drug him to the floor and started chest compressions. And then the emergency, you know, police and emergency personnel arrived. My wife went and got Narcan before they arrived and applied that, and that didn’t do anything.
Bernstein: That’s the antidote that reverses an overdose.
Bernstein: It didn’t work?
Burke: No. And the emergency personnel worked on him for 45 minutes while me and my wife sat downstairs in the kitchen. And then finally they came down and said that there was nothing more that they could do. So we had to sit there and wait on the coroner to pronounce our son dead. And then we went in another room while they were bringing his body down.
Bernstein: And what had he overdosed on?
Bernstein: Heroin. And do you know how he obtained it?
Burke: Not exactly.
Bernstein: Dorie, the grief group that we—well, can you tell us about the year since Thad has died? It’s sort of ridiculous question, but what has the year been like for you?
Burke: Well, my sister-in-law shared with us about a group she went to years ago out in Indiana called GriefShare. And it just so happened that a local church had one that had started up. It’s like a 13-week thing. And we jumped in like about week four. Thad was 11 days gone. And that was really helpful, to go through the—I don’t know if instruction is a good word—just to go through with other people, you know, through their grief and just talk about it. And it’s a faith-based program, so that was a good fit for us. And as we went along I thought, “Okay, so I think we’re doing okay here with our grief thing, doing things the right way.” And then we went to an event in Williamsport, Savings Lives for Zachary, and met David Bower. And he told us about a group that meets, and we’ve been going monthly there. And it’s, you know, we cry together, we laugh together, but we all have unfortunately one thing in common.
Bernstein: In talking with all these folks, have you learned anything about grief, about moving on, about this particular way of losing a child? There’s no way, I think, to describe losing a child. But in this epidemic has it been helpful to meet with other families?
Burke: Yes. Yes. And one thing I learned right away was just that there is nothing that I could have done.
Bernstein: In the beginning you were pretty guilty about the death? But they’re telling you you couldn’t have—
D Burke: Right. There’s nothing I could do from May 21st, 1994 to October 2nd, 2016, nothing I could have done to change. And that’s hard as a mom.
Bernstein: Alice, you spent months on this video. You went up to Williamsport, met with all these folks. You attended the grief group. You have been with them at a 5K run-walk afterwards. What was your ambition when you started, and what did you find out?
Li: I think it was important—and this was something that we discussed early on—that we wanted to show the faces of the people who had really been impacted the most by this epidemic. It’s easy to talk about numbers. It’s easy to talk about the statistics. But to really get to the heart of who this is hurting the most, I think, was something that we wanted to showcase. And so when we first went down to Williamsport and met with Tina , she had told us about this grief therapy group, and it sounded like a good place to meet more families who, as Dorie was saying, unfortunately shared the same thing in common, which was losing a loved one to this epidemic. And so when we first went to the grief therapy group it was in the backyard of the counselor’s home. It was a beautiful evening. And it was just—yeah, it was heartbreaking hearing all of these stories and going to the 5K and 10K run and seeing how many people had been impacted in this community by this epidemic. And I’m actually curious too to hear—I mean, when you guys—because you guys were also at the 5K-10K run. Were you taken by surprise by how many people this had impacted and touched, or was this something that you were aware of even as your own son was going through this?
Burke: So last year was the first year that they did that 5Kk-10K, and it happened to be probably about three weeks after Thad passed. And my sister who lives in the Williamsport area, she said, “Hey, my friends want to start a team for Thad.” So we had—there were probably 30, like my nephews, their friends, you know, family. And I think last year, the first time ever, they had over 600 people at the 5K-10K thing. And so this year I think it surpassed that. And, yes, I was surprised, because everybody has a story whether it affects them directly like as it did us or it’s a nephew, a cousin, a friend, a grandchild, so.
Bernstein: It seems like there is no more than one degree of separation at this point in the epidemic. If you don’t know someone who has died personally then you have a neighbor or a cousin or a nephew or someone who knows someone who has died.
Burke: And so many of the stories are the same, about how it starts with painkillers. You know, I’ve heard so many stories like that, you know, that it starts out with painkillers and then it progresses to heroin or other substances.
Bernstein: His injury was a football injury? I don’t remember.
Burke: No, it was an accident.
Bernstein: An accident?
Bernstein: Yeah, and then the painkillers were prescribed at the hospital?
Bernstein: Alice, were you surprised by anything you found in doing the work on this?
Li: I think I was surprised by how many people were at the race, honestly. That did take me aback a little bit. I think especially when you’re physically in that space and you’re seeing everyone who is there and how many people have been impacted by it, it is kind of—and, you know, Williamsport, for people who don’t know, it’s the home of little league baseball. So you go there and there are statues of little kids who are playing baseball. It is as American pie as you can get. And so it is kind of this disconcerting environment to be in while you see all of these families who have been impacted by this epidemic.
Bernstein: At the moment there are three U.S. senators waiting to come out here and speak on the opioid epidemic. There are a whole bunch of folks here from the DC area who may be able, in their own corner of this world, to be able to do something. As parents of someone who passed, who overdosed on opioids, what do you want them to do? Not speaking as policy makers or anything, what needs to be done to bend the curve on the opioid epidemic?
Burke: Well, as people have seen from the 60 Minutes episode, that one bill needs to change. And for the life of me I can’t understand why attorneys for the DEA switched sides. And it’s unethical; it’s immoral for them to switch sides to be attorneys for the DEA and then be attorneys for the big drug companies. That’s just something I can’t understand.
Bernstein: And you’re in the law enforcement world yourself?
Burke: Yes. And when I was first told about it a couple of months ago I thought, “Well, I’m against anything—” You know, I work at a federal prison. I’m against anything that ties the hands of another federal law enforcement agency to effectively do their job.
Bernstein: How about treatment? Was it difficult, Dorie, for Thad to get treatment? We’ve already pointed out that it wasn’t the most effective, although relapse is such a difficult subject.
Burke: Right. Our daughter researched—because we were like so naive. We didn’t know how to do anything. You’re just going like, “Okay, find him a place to go.” And we’re like, “Okay.” But our daughter is quite the researcher. And she found Marworth. And Thad loved to lift weights, and he was at the gym every day. And she said, “Mom, I found one that has a little gym.” And so everything just fell into place. And it wasn’t terribly far from our home. And so we’re just—yeah, wish the end results would have been better.
Bernstein: Was there a reason? Do you have any reason why you think Thad relapsed twice?
Burke: Now I think maybe the anxiety of his upcoming just drug court, maybe being nervous about “What if I fail?” because he had friends who he met through meetings and things that were going through it and maybe had not done well and failed, and he didn’t want to go back to jail.
Li: And, Todd, I see you actually have a tattoo of Thad. Do you mind showing that?
Burke: Yeah, this is a portrait I had done of my son I think in December. And then this was the first tattoo that he had. This is the crest for Bern, Switzerland. That’s where my great-grandfather came from. And then this I had done in June, the 28th I think. And he had this on his back. So I wanted this arm to represent my son. So my son is always with me in my heart, and he is here on my arm. And he is here, his ashes, some of his ashes are in here. This is what we take when we travel places so that our son is always with us. Sometimes we take this if we’re going somewhere to spread his ashes like at his grandparents’ house, different places in Pennsylvania, and out in Indiana at the lakes where he liked to go. But when he passed there was like about a little bit left in here. So I dumped that out and I put some of his ashes inside of it. It’s a pre-workout drink.
Burke: And he didn’t like to travel so much. So it’s kind of one of those “[LAUGHS] Gotcha.” [LAUGHTER] At least for me.
Bernstein: That’s all the time we have for this session. Todd and Dorie, I really want to thank you so much for coming down and speaking. Your story is heartbreaking and hopefully effective in the war on opioids. And, Alice, the video obviously speaks for itself. So I’m going to turn this over to my colleague Mike DeBonis. He is going to ask questions in the next panel. And thank you all very much for listening.
Burke: Thank you.
Lawmakers Respond to the Crisis:
DeBonis: Hello, everyone. Good morning. I’m Mike DeBonis. I’m a Congressional reporter with The Post. I’m joined now by two senators who have seen their states affected by the opioid crisis and are working to find solutions. Please join me in welcoming Senator Maggie Hassan and Senator Rob Portman. [APPLAUSE] We also have Senator Joe Manchin who is hoping to join us today. He’s been delayed a little bit. Perhaps he’ll be joining us a little later. But we’re just delighted to have two leaders in this sphere who have been working everyday.
Senator Maggie Hassan is in her first term representing New Hampshire. Her efforts to combat opioid abuse did not start in January. During her four years as governor she worked across party lines to secure funding to strengthen prevention, treatment, recovery, and law enforcement efforts in her state. New Hampshire increased penalties for fentanyl distribution, began investigating opioid overdose deaths as homicides, reformed the state’s prescribing rules, and expanded the state’s prescription drug monitoring system. She is a member of the committee on health, education, labor, and pensions. And she’s a cosponsor of multiple bills to address the epidemic.
Senator Rob Portman of Ohio, delighted to have you here. Senator Portman is in his second term representing Ohio. He is a former director of the office of management and budget, former U.S. trade representative. He is one of Congress’s foremost experts on fiscal and trade matters, but he’s also had a long interest in combatting drug abuse dating back to his days as a house member. He established an anti-drug coalition in his hometown of Cincinnati. He is the author of The Comprehensive Addiction and Recovery Act, which is the first major reform of federal addiction policy in two decades, which was signed into law last year. And he is chairman of the senate’s permanent subcommittee on investigations where he has done some significant intensive oversight on the response to the epidemic. Thank you, Senator Portman for being with us today.
And to those watching, I want to invite you to please tweet your questions at us. We’re collecting them under the hashtag #PostLive. So hashtag #PostLive, send us your questions, and we’d be delighted to answer those. Let me start with as a member of The Post, when we have an investigation that’s had an impact as we saw on Sunday, it’s important to address that. And I want to ask you both. But we learned through this investigation—most of us, a lot of us—that Congress acted last year passing a bill that key figures of the DEA say took tools away from them that they needed to combat this epidemic. Both of you are authors of legislation that aim to stop the epidemic and help its victims. When did you learn about the effects of this particular bill, and what is your reaction to knowing that you may have—you know, in your case, Senator Portman, you were in Congress when this happened—that you may have played a part in supporting a bill that may have exacerbated the crisis? And just so people understand, this is a bill that passed by unanimous consent, Republicans and Democrats alike. Any one senator could have stopped the bill, but it seems that there was just not an understanding of what the impacts of this bill would be. Senator Portman, I’d ask you to start.
Portman: Yeah. Thanks to The Post I learned about it. And I think that’s true with, I would assume, if not all, most of my colleagues. You know, it’s a complicated issue, opioids, and it requires a comprehensive response obviously. And that’s why the Comprehensive Addiction Recovery Act last year was landmark legislation, as you said, because it covers the whole gamut. Some of the legislation actually got weakened in a conference with the House on the prescription drug area, which is why we have reintroduced legislation that’s actually a little stronger than our original push that got knocked out in the House on prescription drug monitoring. And Maggie is a cosponsor of that bill. Amy Klobuchar and I are the coauthors. I think on this particular one, I mean, I frankly asked my office, “Did we hear from anybody?” And the answer was no. And the irony is that it actually passed the judiciary committee. I’m not on the judiciary committee, but it went through the judiciary committee at the same time as the Comprehensive Addiction and Recovery Act. I think a lot of the focus was probably on the opioid crisis and the prevention, education, treatment, recovery, and Narcan, which is the miracle drug that reverses the effects of overdoses, that focus was on the Comprehensive Addiction Recovery Act. And that may have been one of the reasons this sort of slipped through, because apparently it was unanimous consent in committee, unanimous consent on the floor. But obviously that’s one of the issues that we need to now relook at. We need to go back and examine that.
I did look this morning at what the DEA enforcement actions were around that time. And they were significantly reduced before the legislation was passed. So there was actually already a pullback of the enforcement actions. But, you know, again, it’s a very complicated issue. There is no silver bullet. There is no one way to address this issue that will solve the crisis, because it is a crisis. We just got to meet the family coming out who we saw briefly here. And Maggie and I have—I mean, I’ve met with probably 1,000 addicts, recovering addicts in the last couple of years alone. I focus a lot on that issue, but everybody has.
So I think you have to start with the drug companies coming up with a non-addictive pain medication. There was a taskforce recently established under CARA, the Comprehensive Addiction Recovery Act, by the administration. In fact, applications are being accepted now for people to be on that taskforce. We need to push the drug companies to come up with non-addictive alternatives. I mean, it’s crazy that we’re using opioids for things like extracting a wisdom tooth. It just doesn’t make any sense.
And then the distribution network, which is the focus of that story, is obviously a huge part of it. The Prescription Drug Monitoring Act—that, again, I encourage members to cosponsor and let’s get the darn thing passed—requires states to have a prescription drug monitoring program that holds the pharmacies and the doctors responsible on the prescription side to stop the overprescribing. It also requires states to get involved with the interstate compact so that you have interoperability. In Ohio people will get the prescription in Ohio. Then they go to West Virginia or Kentucky or Michigan or Indiana or Kentucky, somewhere else, to get another prescription filled. We’ve got to stop that. And then obviously on the treatment and recovery side, Narcan and the enforcement side.
And we have another bill, Maggie and I, and, again, it’s a bipartisan bill that deals with how do you keep the illegal drugs from coming in, and that’s the STOP Act.
DeBonis: Right. And I want to certainly talk about the STOP Act a little later. Senator Hassan, let me ask you. What is your reaction to these revelations? I know that you have some tough questions and had some tough questions for the DEA. You would expect the agency that’s enforcing these laws to speak up when Congress is about to act to take tools out of their toolbox. What is your reaction to what happened here?
Hassan: Well, first of all, as is true with Rob, I have been meeting with and hearing from families, people who have struggled with addiction, people who have lost people to addiction ever since I got into office. But particularly over the last three to four years in New Hampshire the epidemic has just spread like wildfire. And part of what we see in the story that you all broke is the structural underpinnings of this epidemic. And while it is very true that we have been focused on prevention, treatment, recovery, law enforcement, one of the other things I did as governor was with Republican colleagues in the legislature stand up Medicaid expansion so that people could actually get treatment. It’s a critical part of the Affordable Care Act that also requires private insurers to cover substance misuse disorder.
So while we have been focusing on what I would call getting resources to the frontlines and we need you to do much, much more on that, the structural underpinnings of this epidemic are much harder to crack because of the various forces involved. So along with Senator McCaskill and Senator Manchin I’m on a bill that we filed I think it was yesterday to repeal the law that passed by unanimous consent now that we understand what the impact really has been. But at the end of the day I think that one of the things that has been a real challenge here is that there are all these structural components.
There is a pharmaceutical industry that encourage doctors to treat pain as a vital sign and use opioids aggressively. There are doctors who—obviously the vast majority of them train to help people, alleviate pain, save lives. So they were, I think, somewhat resistant at the beginning to think that they had a role in this, so changing prescribing rules was difficult. We have drug companies making enormous amounts of money on these drugs. And then we have an epidemic in which the people who are suffering from the disease are stigmatized. And I really do think if this were an epidemic that did not carry the stigma that substance use disorder does, we might have gotten at these structural issues sooner. So we still have a lot of work to do, and we still have to push incredibly hard in addition to asking and encouraging and providing incentives for drug companies to find non-addictive pain relief. We also have a medical device industry that actually does have some non-addictive alternatives for pain treatment, but they can’t get coverage through things like Medicare and Medicaid for those. So there’s a lot of work to do.
I will also just say how grateful I am not only from the family we just heard from but throughout my state, throughout Rob’s state, around the country people suffering from addiction and their families have stood up. Parents have begun to write breathtakingly difficult obituaries about their children. They have brought attention to this by being willing to stand up and stalk about their pain, their suffering, and this disease, and that’s what’s going to make a difference ultimately. That’s how we’re going to beat this thing.
DeBonis: Thank you, Senator Hassan. Well, we are joined by Senator Joe Manchin.
Hassan: Hey, Joe.
Manchin: Hey, how you doing, buddy?
Portman: Joe, how you doing? Good. Good to see you.
Manchin: Traffic was horrible. [LAUGHTER]
DeBonis: Thanks, Senator.
Manchin: Thank you. I’m sorry.
DeBonis: Three is always—you know, always great to have a trio with us. I’ll give a brief introduction to Senator Manchin who has represented West Virginia in the senate since 2010. He has worked tirelessly to bring attention to the toll of the opioid crisis in his state well before the national dimensions of the epidemic became known. Among the efforts that he has been involved in he was a leader in the effort to get hydrocodone rescheduled, a very powerful opioid.
Manchin: Vicodin and Lortab from Schedule III to Schedule II.
DeBonis: Right. And that’s meant quite a dramatic decrease in the number of prescriptions for that particular drug. He has cosponsored a number of bills related to the crisis. He is a cofounder of the prescription drug abuse caucus. And he talks about this almost every single day. Let’s be honest, every single day you’re talking to constituents, you’re talking about this issue. Thanks for joining us.
Manchin: Thank you for having me.
DeBonis: Senator, I know that you saw the report that we had in the paper on Sunday—
Manchin: Yeah. Thank you.
DeBonis: —that we did with 60 Minutes.
DeBonis: You’ve spoken out about it. You called for Representative Marino to withdraw his name. Let me ask you this though, because I gave Senator Portman a little bit of a hard time here before you showed up, but you too were in the senate last year when this bill passed by unanimous consent.
DeBonis: What was your reaction when you learned, as the author of a number of bills to address this epidemic, that you may have let a bill through that may have made it worse?
Manchin: We were incensed, because when you look at the whole timeline, in 2014 Congressman Marino put a piece of legislation in the House. It had great resistance from the DEA and the DOJ, saying it would harm their ability to do the job their supposed to do. They went back and reshuffled it a little bit more. They hired people that were on the DEA, which is Mr. Barber.
Linden Barber was able to write and smooth it over. It then went through, no objections whatsoever from the House in 2015. It came over to the senate. It came into the senate, and they worked on the language some more to make it smoother. Then there is no objections. A UC means that basically if it comes out of the committee, the assigned committee, and there is no one—if we’re not on those committees and our staffs not intricately involved in it, we rely on the agency. So if the DEA and the DOJ said, “We think this will not harm them whatsoever; we just want to make sure that the patients that are in severe pain, end-of-life, cancer are going to get what they want.” We never intended to remove them from it. But it was never intended to be a wholesale market to open up the floodgates. Because in West Virginia the floodgates were already open.
I have one little town, Kermit, West Virginia, 392 people, nine million pills in one pharmacy. Now, you tell me something wasn’t flagged there and why it shouldn’t have been flagged. So everybody is at fault here. How do you stop it? Well, you stop it by getting the enforcement people back to do their job. Do you stop them from going from one, from the DEA, the people that know what to look for and how to investigate and how to prosecute, from the DOJ, and prevent them from going into the pharmaceutical industry business within the same week and get a big paycheck.
DeBonis: And just to be clear, this is not a partisan failure. We had Republicans and Democrats cosponsor this. President Obama signed this bill.
Manchin: Rob, he’s got as much problems in Ohio as I have in West Virginia, as Maggie has in New Hampshire. This has been a silent killer, and it doesn’t have partisanship. It’s Democrats, Republicans, independents. It doesn’t care about who you are; it’ll get you. And we keep our mouths shut because as family members we were afraid to embarrass anybody or embarrass ourselves. So every family member I know in everybody sitting in this audience probably knows somebody that has been affected.
DeBonis: Yeah. Before we move on, I want to ask one last question to each of you. What needs to be done to fix this? Should this bill, the Ensuring Patient Access and Effective Drug Enforcement Act, be repealed or at least the provision in question here? Would you all support that? And what are you willing to do to make sure that happens—
Manchin: Well, first of all, we’ve already cosponsored it with Claire McCaskill right now. And I’m sure it’s going to be a bipartisan effort. No one intended for this to happen.
DeBonis: Senator Portman?
Portman: I was happy to see this morning that the judiciary committee agreed to hold a hearing. And that’s the first step toward addressing the issue. It’s got to be reexamined, and it will be. And I think it will be bipartisan, as Joe says. So that hearing will take place soon, as I understand it. And, again, when I looked at the data this morning, the enforcements were already down before the legislation passed. So it’s a deeper problem than just the standard of proof, which is what changed in that legislation. There used to be—you know, and this was in the Obama administration. Now we’re in a new administration, but it’s the same career people there who need to be given the tools to be able to do their job.
Hassan: And I just would say that, to Rob’s point, it seems that there was this concerted effort by the industry to get the DEA to kind of work, quote, “with them.” The administrative law judge who you all cited in your reports, I read some of his article yesterday. And he said the language just about makes it impossible. And so now that we’ve got a judge in charge of interpreting the law saying the language, whatever it was intended to do, this shouldn’t have been the result.
DeBonis: Just so people understand, this is the person who’s job it is to interpret the regulations and say what they do and what they don’t say. As you learned in your hearing in the health committee yesterday, the DEA takes a different view even though—
Hassan: Well, no, this was the industry. When I asked the industry whether the judge was wrong who said that the law made it impossible to really bring enforcement actions suspend shipments of opioids, the judge said it was impossible. I asked the industry about it yesterday. They said the judge was wrong, and they weren’t misleading the public. So we’ve got some work to do.
Manchin: I mean, the whole—the phrase was—the substitute amendment was, “A substantial likelihood of immediate threat” changed everything.
DeBonis: Well, Senator Portman, I just want to follow up with you. Do you think—you chair an oversight committee, the permanent subcommittee on investigations. Do you see some opportunities? I know you’ve done a lot of work on opioids. Do you see any opportunities on this particular issue to step in, or are there other committees looking at this?
Portman: Well, judiciary is going to look at it. They’ve already made a decision to. They’ve got the jurisdiction. But sometimes we manage to prod those committees to be a little more aggressive. And we have done a lot in this area, so it would not be inappropriate. Let’s see what the judiciary committee does. I think this will move pretty quickly.
Hassan: There are other things to do in addition to this, obviously. And I don’t know if that’s—
DeBonis: Well, yeah, let’s move on. I think one thing that’s out there I think we’re all at least somewhat familiar with is that there is a White House commission looking at this, have been looking at this for a number of months. They’re due to put out a final report by the end of the month. But we already know they made interim recommendations in July, one of which was to declare the national emergency. That’s something that got a lot of attention at the time. It hasn’t happened yet. We heard the president earlier this week sort of indicate that that may be happening soon. Can we talk about that declaration of a national emergency? What does it mean? What doesn’t it mean? How important is it? Or is it sort of shorthand for other things that need to be done?
Hassan: Well, we’ve been waiting for details on what the president and the commission actually mean. Because, as Joe knows as a former governor like me, the type of emergency you declare matters in terms of what resources you then can actually deploy. And so we’ve been waiting for details from the White House. It was very disappointing that the president said we were going to declare a national emergency, which I assumed meant and then really garner some resources, because while the CARE Act really—CARE and Cures really helped us get some resources out in the field, they aren’t nearly enough. And we’ve talked to the commission too about the distribution formula. New Hampshire has one of the highest per capita rates of deaths from overdoses in the country, but we only got $3 million of the money, of the $500 million. But at the end of the day this administration has said that it cares a lot about this and then just not followed through, and we are losing people every day.
Manchin: If I may say that, you know, in my state I am the highest. I have more deaths per capita than any state. And it’s affected every area of my state. In southern West Virginia and the coal fields it most direly got hit hard. So, you know, I go around and I being governor, former governor, and now being in my position with the U.S. Senate and seeing the devastation that’s gone on, and how do you affect it? Well, no one has it with treatment centers. First of all, we were all in denial thinking that if you were addicted you were a criminal. “We’re going to put you away.” Well, we did that—
Manchin: —for 20 or 30 years. We never cured anybody. And so now we understand, those who are not naysayers or deniers, that addiction is an ailment, and an ailment needs treatment. And if you don’t have treatment centers, forget about it; you’re not going to cure the people. So we’re starting in West Virginia. We have to start with pre-K. Pre-K up as far as education in schools what this does. We have no place to put the children when we take them out of a drug infested home. Foster care is almost impossible to get. So we have people talking about orphanages again to try to get them out of a drug infested home. How do you clean a person up if you don’t have treatment centers? So I introduced a bill called LifeBOAT. I’m going to charge the manufacturers—they can’t pass the cost on—one penny per milligram for every milligram they produce of opiates in the United State of America. That produces one-and-a-half to $2 billion, one penny. And they’re not going to be able to pass that through. Everybody says it will be a tax increase. It’s not. It’s a treatment. And we can start putting these treatment centers and helping people in the most infested areas.
The second one, we can’t get people into the workforce. I’m down to 50% of my adult, working-aged people able to work because three things keep you out of the workforce. You either have addiction, you have incarceration or a record, conviction, or you have a lack of skillsets or a combination. Well, I can tell you, if you’re addicted, you’re going to end up with a criminal record, probably larceny. And then we have no way to get them back in because we put them in jail. So I said if it’s not a criminal, if it’s not a violent crime or a sexual crime, the person goes to one year of treatment and passes, one year of mentoring, helping other people, they ought to have a right to go back to their sentencing judge to see if they can have that one-time expungement.
DeBonis: Right. Senator Portman, I want to ask you this because you’ve been outspoken in saying it’s not just about the laws and it’s not just about the regulations; it’s about the funding. You’ve worked to try and get the funding in place. Some of that was done in CARA; some of that was done in 21st Century Cures, another bill that passed last year. But you’ve said there’s more to be done. How does declaring an emergency help? Or is the bigger issue getting Congress to act, appropriating money to actually get people the help they need?
Portman: I think it’s both. I mean, what’s happened in the last year and a half is really positive. Congress did pass the CARA legislation. It took us four years to put it together and to get the support for it. We had conferences here in DC, brought best practices from all around the country. It’s the first time Congress has ever acted as an example to fund recovery programs. To the point that Maggie and Joe made, this is not going to be solved with only one approach. It’s got to be multifaceted. It has to include, in my view, not just treatment but long-term recovery. And that’s what this legislation does. And, as Maggie has said, it does provide grants to the states. We actually overfunded it this year, and that was a really good sign. I mean, my concern was that we weren’t going to provide enough funding, given all the budget pressures. We actually funded more than was authorized.
Hassan: We’ll take some more. [LAUGHTER]
Portman: And we need more. And that was in the last year. And now we’ve passed the Cures Act also. Cures is different because it sends the money directly to the states. So CARA can go directly—for instance, we just had three grants in Ohio that were announced that are going to nonprofits and going directly to service providers. But Cures goes directly to states. That’s a half a billion dollars a year. That’s for this year and next year but then nothing beyond that. So we’re going to have to be sure we get that 500 million again in this fiscal year, get as much as we can, because the crisis is not getting better; it’s getting worse. And then we’ve got to be sure that we have a longer-term strategy. Some of us have been working on that to try to figure out how do you have something that’s more permanent so that states can plan. But all that’s going to be needed.
So the commission, I think, did a good interim report. You know, I’ve testified before them and talked to them. I spoke to Governor Christie over the weekend again about the final report. I think he is impassionate about this and committed to it. He is the chair of the commission, as you know. And actually the report was due on October 1st.
DeBonis: Right. They asked for an extension.
Portman: So they asked for an extension, and that’s fine. I just want to be sure that they do meet the end-of-the-month deadline. And—
DeBonis: Right. And Governor Christie may—that’s his intention?
Portman: That’s his intention, and, again, he is passionate about this. And, you know, he has got a personal commitment to this that is impressive. But I’ve got to tell you I don’t think the national emergency is as important as sort of what results in terms of Congress, because the administration can’t appropriate money. What they can do—and this is positive. And I have met with the president personally on this very issue—is they can declare an emergency that requires all the agencies to work better together. So I mentioned interagency taskforce on coming up with new non-addictive pain medication. If the agencies are all told by the top, “This is an epidemic,” which it is, “This is a national emergency,” it’ll make a difference, and that’s good. But Congress has to also view this as an emergency, and that requires us to do a better job of providing some longer-term funding here and not just funding. It’s not a matter of throwing money after the issue; it’s a matter of finding what works. And, again, what CARA did after four years of study is, you know, what kind of treatments work better than others. The need for longer-term recovery was evident from all the research we did. The need for us to deal with this issue at every level—we’re going to talk about the STOP act in a second, I hope.
Portman: But there are more people dying in Ohio today—and I think the same is true, Joe, with your state—from fentanyl than from heroin.
Manchin: Sure. Mm-hmm.
Portman: And fentanyl is a synthetic form of opioids. It’s coming in from China mostly, coming in by the U.S. mail. That’s an outrage. We’ve got to deal with that. And unbelievably the STOP Act, which Maggie and I have worked on for about a year now, has been stuck in Congress. And that should pass.
DeBonis: Before we move on to the STOP Act, I do want to save some—we’ve got a couple of questions coming in from our viewers that I want to get to eventually. But absolutely let’s talk about the STOP Act. Senator Hassan, fentanyl, as we’re learning every day, is an incredibly powerful drug that’s killed people. It’s affected innumerable lives, and we have this problem that it simply is coming in through the mail from overseas. Talk about the problem, and what the STOP Act is about.
Hassan: So, in New Hampshire, 70% or so of our overdose deaths are a result of fentanyl overdoses. And so, it is 50 times more powerful than heroin. We’ve also had 10 deaths from carfentanil, which is 100 times more powerful than fentanyl, and was really intended only to tranquilize large elephants. So, these drugs are synthetic. The profit margins, because they’re easy to make—you don’t have to grow a plant as a precursor here—are huge, and they are flooding particularly rural areas of our country.
I do just want to add one other thing to the overall picture here of what we need to do. The last thing we should be doing is destabilizing and repealing our healthcare in this country, in terms of making sure that there is treatment accessible to people who need it. So, in this mix, while we talk about the STOP Act, which is critically important to getting data, so that we can go after these fentanyl producers and dealers, we can’t ignore the fact that an integrated healthcare system that treats behavioral health and substance use disorder is an absolutely essential piece of this. And if we repeal the Affordable Care Act, if we cut Medicaid substantially, if we fail to invest in long-term treatment, and have a variety of treatment modalities for people, we will not turn the tide on this thing and beat it.
DeBonis: Senator Portman, quickly, the STOP Act, it seems like a no-brainer, that we would want to crack down on something like this. Why is it so difficult for Congress to act to change the law to keep these very powerful drugs?
Portman: Honestly, I can tell you the reasons but it’s a mystery to me, because here’s what’s going on, and this is a shock when people find out. Fentanyl, which is again, killing more people in our states that heroin now, is coming in through the U.S. mail. This is not coming overland from Mexico like heroin, and it’s not even coming from a country next to us; it is coming mostly from China, and they choose the U.S. mail, because the U.S. mail system does not require that packages have information on it for law enforcement to be able to stop this poison.
If you’re FedEx, UPS, DHL, you’ve got to provide advanced data that says, this is where it’s from, this is what’s in it, this is where it’s going. Law enforcement—and I’ve been to the DHL screening and the UPS screening, I’ve seen them do it; they go in there with customs and border protection people and DEA, and DEA is strongly supportive of our efforts, by the way, and they’re able to identify these packages. It’s like finding a needle in a hay stack if they don’t have that information. And as a result, you can get a package the size of that clock that can 100,000 doses in it. Three flakes of this stuff can kill you. This is incredibly powerful, incredibly cheap, and at a minimum, we ought to be giving our law enforcement officials the ability to find these packages and stop them.
Again, that’s not the only solution here, because that’ll increase the cost, and get a little bit less on the street, but we still have to deal with the broader issue, but that is a no-brainer to me.
DeBonis: I do want to turn to, and Senator Manchin, I want you to field this. This is a question from a viewer. Jasmine asks on Twitter, to what extent is harsher punishments for fentanyl a solution to the broader crisis? And I know there is bills out there. Senator Feinstein I know has one that are involved in that aspect.
Manchin: I’m fine with anything that does work, and if it’s more effective, the bottom line is, unless we do something with the Chinese government and they get serious about shutting this thing down, they know where it’s—we all know where it’s coming from; they know where it’s coming from, and until Wilbur Ross, the Department of Commerce, and this administration get serious in trade and everything that we do and all the pressures we can put sanctions, and we can tell them how serious, we’re not going to let them keep killing Americans. They’ve got to know that this is serious, and we are not standing for it, and we’re not going to tolerate it.
We can shut everything down; we can try to stop the flood, if you will, but unless the Chinese government is real, and gets real about this and sincere, knowing that we’re sincere, and that we’re going to do everything we can through sanctions and trade agreements, and everything that we can to put pressure on them, if there’s no quid pro quo offense to those, the money keeps pouring in, they’ll keep doing it.
DeBonis: Like those two indictments this week of Chinese nationals as traffickers—really significant, because that’s the first time that the Justice Department has taken that—and they don’t issue those indictments lightly. So, finally we’re—
Manchin: It’s moving in the right direction. It’s just moving too slow.
DeBonis: There is absolutely a criminal justice aspect to this here. Senator Manchin, I think you’ve been sort of outspoken in saying you can’t incarcerate your way out of this problem. You have to treat this as the illness that it is. There’s another very question here coming to us from a viewer. Victoria on Twitter asked what do senators think about establishing safe injection sites to help curb the crisis? In other words, giving addicts a place where they can go and be monitored while they use. I mean, we’ve heard about other harm reduction, risk reduction strategies like needle exchange, etc. Is this something that’s worth exploring?
Manchin: Let me just talk about methadone suboxone, okay? We have certain people that recommend this is how you should bring them down. And we have other people that says, absolutely not, I’m an addict. All you’re doing is extending—you’re just stringing me out. So, everyone has a different approach. I can just tell you, we have a recover—we have places in West Virginia, treatment centers called Recovery Point. Recovery Point takes an absolutely clean slate and goes with it, and these are all run by severe addicts, people who almost bottomed out, and they’re all working and running these Recovery Points.
They do not tolerate suboxone. They do not tolerate methadone. They do not tolerate any of that, and they’ve got a 68%, basically, cure rate, but they really work with these people and they monitor. They’re on 24/7, a minimum of 12 months, and that’s what it takes when you have been addicted to the point that America is addicted, and West Virginia has been addicted, but I’m not knowledgeable enough to say, “Oh, yeah, bring them down with legal—”
DeBonis: Senator Hess, I’m going to give you the last word, because we’re running out of time.
Hassan: I will say that what we know is that different people need different kinds of treatments. We also know that there’s a whole secondary set of medical problems like Hep C and cardiac problems that come from ongoing addiction. So, we need to be smart, we need to treat this as the disease it is. We also need to hold people accountable, which is why drug court programs with treatment options are so important, but we’ve got a lot of work to do. Again, we’re losing people every day to this horrible disease.
DeBonis: Senator Portman, I’ll actually give you the last word.
Portman: Look, I don’t disagree with what was said. I just—I think, again, going back to the drug companies, and the need to come up with non-addictive pain medication, we also need better medication, and this is what CARA tries to incentivize through some funding, to come up with other treatment options. Joe’s talked about methadone and suboxone, and I’ve heard the same thing from a lot of addicts. I think Maggie is right that it needs to be customized to the person. Vivitrol is now out there; most of our drug courts in Ohio are using Vivitrol, which blocks the craving as opposed to continuing the effects of an opioid, and that’s been very successful for some people.
But it is incredible to me that we don’t have more options out there for people to look at, that are non-addictive options to get people through that difficult period of recovery. And I think that, again, if you look at this in a broad sense, we got to go back to the core here. How do we stop people from over-prescribing, to getting addicted in the first place? Probably four to five heroin addicts in Ohio started on prescription drugs, and how do you come up with, therefore, not addictive medications? And then at the other end, how do you come up with better therapies? And if it’s really an epidemic, which I believe it is, and we really have a national emergency, that ought to be part of the focus.
Manchin: Let me just say—
DeBonis: Very briefly.
Manchin: Very briefly. If it wasn’t for The Washington Post article, what you all have done, and I read it Sunday. Immediately, when I read it, I called all my staff. I knew right then that Congressman Marino was not the person to be leading the drug czar. There’s no one in West Virginia would believe after that article, and also you all collaborating with 60 Minutes, would have ever believed that he was going to be fighting for them. It was not personal against him, whatsoever, but the position he’s taken, and how he was so involved was the wrong person.
I applaud the president for moving as quickly as they’re moving, in a different direction. I think the White House is sincere about this. Now it’s time to take action and I want to thank you all, because if you hadn’t done that, this would still be simmering.
DeBonis: We appreciate the kind words, Senator, but thank you for joining us today. Thank all the senators for joining us. Big hand for them.
Hassan: And when you get a chance, thank first responders.
DeBonis: Absolutely, and Senator Hassan makes the tremendous point, thank the first responders who are, on a daily basis, responding to people in crisis. And we’re going to move on now to the next portion of our program, if you bear with us for just a moment. Thanks again.
Where The Story Goes From Here:
Casey: It’s so great to see all of you here. I’m Libby Casey with The Washington Post. I’m one of our on-air reporters, and I’m joined by the team that made this story happen. And it’s great to have you guys on stage, and get to hear from you in person. Lenny Bernstein, health and medicine reporter here at The Washington Post; Scott Higham, investigative reporter at The Washington Post, and Ira Rosen, producer at 60 Minutes, who made this piece happen from the 60 Minutes perspective. So, we’ll talk about two things in the next little while. Where we go from here, but also we want to start with how this collaboration came to be, because The Post and 60 Minutes haven’t worked together on something like this in nearly a decade. So, let’s start with where does a reporting story start? Lenny, how did you even get the idea? We see the end result 18 months later; where did this piece start?
Bernstein: So, in the beginning of 2016, we had a project launched on the national desk at The Post, and the idea was to try to explain to people why so many people were dying of opioid overdoses, particularly in middle America, particularly middle-class whites, and I had an editor who said to me, “I want you to explain how all these hundreds of millions of opioid pills get on the street. It doesn’t make sense to me why we can’t just keep them in the supply chain.”
And so, I started reading up on it, and I started calling around, and indeed, there had been a lot of coverage of the manufacturers, and the doctors and the pharmacies, but nothing on these wholesale distributors. So, I realized there was an opportunity to write about their role. I started calling around and eventually, someone said, “You’ve got to call Joe Rannazzisi. This is what he’s been doing for the past decade.” And I did, and pure luck, he had just recently been forced out of his job. He was very upset about what was going on, and we started talking.
Casey: You got an earful.
Bernstein: I got an earful, couldn’t get him off the phone.
Casey: Let me just mention, if you want to join this conversation, you can tweet us at #PostLive. We’ll read a comment or two and get our journalists perspective on this. So, the distributors are so key here, and I want to just pause for a moment. These are companies I’d never heard of before, but they ended up being a crucial part of your reporting. Just give us a sense of the scope of this.
Bernstein: So, the distributors are—the three big distributors are among the top 25 largest companies in America; McKesson, AmerisourceBergen, and Cardinal Health, and nobody has ever heard of them. We had not heard of them. They take the drugs from the manufacturer and they bring them down to the pharmacies and other places where we all buy them. That makes them the most important point in the supply chain, if you want to choke off the pills that are getting out onto the street and being used by users and dealers.
Casey: Did you know that story at the time—I mean, you get this guy Joe Rannazzisi on the phone. Do you go to Scott and say, “Hey, I might have somebody here?” How does this collaboration begin?
Bernstein: Well, I was clueless until Joe started explaining this to me, and most reporters have had that conversation where the guy on the other end of the phone says, “Everybody is corrupt except for me,” and then you start checking it out, and actually, everything Joe said checked out. So, I took it as far as I could, but very smart editors at The Washington Post realized that it needed an investigative reporter, and so they connected me with Scott.
Casey: And where did it go from there, Scott?
Higham: Well, we kept hearing these stories that the DEA was slowing down its cases, and in a lot of cases that were being made out in the field against these companies were going nowhere. And they were hitting a brick wall in D.C., so we started putting together a list of people who were working in the field, who had either—were current DEA investigators, or who had retired recently, and just began cold-calling them; calling them at home, calling their cell phones, sending emails, calling people across the country.
And we soon began to connect with people who are very, very upset. This is a—these people work for something called the Division of Diversion Control at the DEA, which is, again, something that Lenny and I had never heard of before. I’ve been a reporter for almost 30 years, and I never even knew that this division existed, and it’s a group of really dedicated men and women who do nothing but regulate the pharmaceutical industry, and make sure that pharmaceuticals do not spill onto the streets.
And so, these men and women were deeply frustrated because they were making cases against these companies to try to stop the flow of drugs, and these cases were getting stalled at headquarters. They couldn’t understand why, and people in these communities were dying left and right, and they were the ones who were on the front lines, so moms and dads and grandparents and brothers and sisters were coming to them, and saying, “What are you guys doing to stop this epidemic?” And they were saying, “Look, we’re doing the best we can.”
So, that was the first thing that we did, is we documented this slowdown of cases at the DEA in the face of what we later found out to be intense pressure from Capitol Hill, and from the pharmaceutical industry.
Casey: How does 60 Minutes get involved?
Rosen: So, we are blessed to be working with these guys. They are fantastic reporters, but I think all of this begins with the fact that people have to trust each other. And I’ve had a relationship with Geoff Lean, who’s a fantastic investigative editor here. We did a story with John Solomon when he was a reporter here, on bullet-led technology in FBI lab, and it resulted in a number of people getting freed from jail, the lab being—changing their analysis of things. So, we had a really great experience to build on.
And Geoff and I had stayed in touch over the years, and we talked about what could we do? What would be the right story to do? And then it ultimately ended up with Marty Baron, and Jeff Fager, who’s the executive producer of 60 Minutes, having one phone call, and this was the first story that I think Marty or Jeff had brought up in the call. And Fager said, “That’s what we got to do.” I was like, let’s hear what else they got. And he said, “No, this is what we got to do.”
Casey: How did he know? What was it about the story?
Rosen: It was—when you have 200,000 people dying in the United States, and still many people are still unaware of the scope of this, that’s a big story. And as I joked with my friends here, is you don’t have 200,000 people dying without leaving a paper trail. And that’s sort of the way I kind of approached it. And what was so wonderful about this collaboration is that each one of us brought a different talent. It’s kind of like bringing three chefs into a restaurant, who each have different skillsets.
So, we were able to share sources, we were able to share kind of editorial approaches. We stole lines from each other’s story. And it was really—and we trusted each other. They looked at our copy, we looked at their copy, provided suggestions both ways, and it was really a true collaboration. I mean, these guys had done a fantastic story in October 2016; unfortunately, it dropped a couple weeks right before the presidential election. So, it was buried; nobody really noticed it. And with the approach to the new bill, it gave it a new impetus to take a second look at the story.
Casey: It’s so different getting somebody to talk to a print reporter than it is getting them to talk to a camera. How did you guys deal with sources, especially Joe Rannazzisi, who really stands out in this story? He’s someone that CBS has called the biggest whistleblower in nearly 50 years, basically.
Rosen: Well, we had a lunch in a Greek restaurant in Arlington, Virginia, and we all sat around for a couple hours, and we chatted, and I think it’s like—it’s the same with any relationship. A certain level of trust develops. And Bill Whitaker is a guy who is a total gentleman, a total honest guy. He’s been in the business forever. He did the interview with Joe, and I think instantly, Bill—
Casey: And that’s, of course, the correspondent on—
Rosen: He’s the correspondent on the broadcast, and I think they developed a great chemistry between Bill and Joe, almost instantaneously. And we all were in the room, and we watched it happen, and the way it kind of unfolded is the interview is going on, and Scott and Lenny are writing down suggested questions, as well. That’s what I mean by a true collaboration. They became co-producers during that segment, while we were doing that interview, and the other interviews, as well.
Casey: I asked Lenny if he’d ever worked with 60 Minutes before, or done something with 60 Minutes, and you looked at me as though I’d ask you if you were the King of England. You were like, “No, 60 Minutes.” Did this feel like a unique opportunity for you guys?
Bernstein: I’m a health reporter; I don’t get an opportunity to work with 60 Minutes that often. I don’t get an opportunity to work with Scott all that often until this happened. So, it was like a dream come true for me. I also want to say that there’s something a little bit magical about when you sit a guy down in front of those 60 Minutes cameras, with Bill Whitaker three feet away. We had talked to Joe many, many times, and we have gotten great information from him, but then you read what comes out of his mouth when he’s talking to 60 Minutes, and you’re like, oh my god, there’s just something about it that gets people to talk.
Higham: And I think it’s a testament to Bill Whitaker’s interview style. I don’t know how many of you have seen him. I’m sure many of you have, but to see him in action, I mean, basically what he did is he sat down, and Ira helping behind the scenes with this, but sat Joe down, and Bill is sitting directly across from him, and their knees are practically touching, and they basically didn’t let him get up for almost four hours. Maybe a bathroom break, but that was it. They didn’t really feed him; they gave him a little bit of water. It was like he was the Bagram air force and he was being interrogated with the CIA.
But you’re being interviewed by a guy who is so skilled, and is such a gentleman, and puts you at ease, and I really learned so much watching Bill interview him. Because he took him from the very beginning of his career at the DEA, and walked him through this entire episode of him being kind of like the insider of the 21st century. And it was a remarkable thing to see, so it was the narrative arc, and Bill just kind of walked him through his own life.
Rosen: The key to a good interview, which Bill certainly knows about, is you have to have a conversation with somebody, like we’re having a conversation here. You have to listen to the person’s answer, not just try to check off and go through questions. And by doing that, it gets him to go to the next level, and it gets it deeper, and in many ways, it’s sort of what television brings to an interview. I’m not saying that newspapers don’t, but newspapers sometimes, they get the quote and thank you very much, we’ll see you later.
And the TV kind of explores the deeper aspects of things. So, it kind of brings it out. So, when you have something like when they were talking about drug dealers in lab coats, that quote that was in the piece, Bill immediately reacted. You know what a horrible thing that is, and sounds it? He said, “I know it, because I was there, and I arrested those guys, and I authorized it.” So, there was a whole sequence that develops from something like that, that you get on TV.
Casey: Let me remind you, you can join the conversation by using Twitter #PostLive. An element of this is the accountability question, and talking to members of Congress. You tried to talk with Congressman Tom Marino of Pennsylvania, who of course was nominated to be the drug czar—no longer is. You guys got thrown out of his office, basically. Is this playing out the way I picture it in my head? You showing up with the 60 Minutes film crew, which is the scariest thing I can imagine coming in through my front door, trying to hold me accountable for something?
Bernstein: Well, I don’t know how many of you saw the 60 Minutes broadcast; I’m sure a lot of you did, because it was one of the most viewed broadcasts in recent history, but when we walked in, and Bill turned to the poor guy sitting behind the desk there and said, “Hi, we’re with 60 Minutes. We’d like to Congressman Marino,” the guy looked like he was going to faint. But I’ve been covering Washington for—I’ve been here for 17 years, and I’ve interviewed lots of members of Congress and lots of people, and a lot of people will hang up on you or they’ll slam the door or whatever, but I’ve never had the police called on me. That was—
Casey: Ira, does that happen to you all the time?
Bernstein: That was new.
Rosen: Only in New York. But no, it never happened before in Washington. And we’ve done a number of these kind of situational walk-ins, and frankly, most of the time, the congressmen come out and try to make the best of it. This was really extraordinary in terms of the reaction.
Bernstein: And to be clear, we made numerous attempts to set up an interview with the congressman. We contacted his office, we sent over emails, so this was kind of our last-ditch thing. It wasn’t like we just wanted to ambush him, but we really felt like he owed an explanation to the public as to why he introduced this legislation, and we felt as a public official, that he should be held accountable for this legislation, and he refused to talk about it. So, we went to pay him a visit.
Casey: Let’s talk about what’s happened since the 60 Minutes broadcast, since The Washington Post piece aired Sunday. The job here is not to decide what change is affected, right? You guys are telling the story and the story has legs of its own, and the public decides where to go from here. But we did see President Trump address this, both in a press conference, as well as on a radio show. He talked about Tom Marino, and the president said that Tom Marino said, “Look, if there’s even a perception that he has a conflict of interest with insurance companies, if even there’s a perception of a conflict, he doesn’t want to have anything to do with it.”
Now, this wasn’t about insurance companies. Do you have a sense that this White House—have they responded? Are they savvy to what the story broke, and what the feature of this was?
Rosen: Do I think the White House was?
Rosen: Yeah, the White House definitely was. And I think they knew that the story was in the works, as well. They didn’t know quite how the impact would be. I think one of the things about a collaboration is it crosses all the various social platforms. You’re covering TV, you’re covering news, you’re covering all the other various things, and we also share an audience. We have different audiences, The Washington Post and CBS. So, they’re—The Washington Post audience is being introduced to 60 Minutes and vice versa, and it actually helps bring up everything.
And I think it helps bring up everything. And I think from what I know, Trump—President Trump is a regular watcher of 60 Minutes.
Higham: Not a regular reader of The Washington Post.
Rosen: Right. And I think that night, he was tuned in, from what I understand.
Bernstein: I think one of the things you haven’t seen is the hundreds and hundreds—maybe we’re into the thousands of emails that we’re getting from people, and they basically are two themes, at least the ones that I’m getting. Number one: it’s—at a time when the press is under so much pressure and under attack from the highest levels of our government, thanks for doing this. And the other one is, I know someone who died of an opioid overdose. And if I had to break it down into two very broad categories, that’s what I’m reading and hearing. And I think those two things, combined with some of the other elements of this story are what’s producing this sense of outrage.
Casey: I want to reflect on a comment that was said to you this morning, Lenny, by Dorie Burke, who was here, of course, with her husband talking about the loss of their son. She said her thought was it just doesn’t happen to us. We’re not the family who would have someone die from this epidemic. We didn’t expect it to touch us, basically. Are you hearing from people who have that same sense of just continuing to get worse, and continuing to affect people on a very personal level?
Bernstein: Well, at his point in the epidemic, it does happen to people like the Burke’s. There’s no more segregating of populations with the opioid epidemic. It crosses party; it crosses ethnicity; it crosses where you live; it crosses all those lines. They’re gone now. In 2016, there’s going to be about 62-, 64,000 people who have died of drug overdoses when the final numbers are in, and more than half of those are going to be opioid overdoses.
So, while the Burke’s were shocked because they are such a normal, average, working class, middle class family and didn’t expect this to happen to them, it does. It happens to everyone at this point, from the wealthiest folks on down.
Casey: Is this going to get worse before it gets better?
Bernstein: I suspect it is. I hope not, but I suspect that the curve has not been bent yet. I fear what’s going on right now. I hear it anecdotally, and there’s early indications of 2017 being even worse. The one glimmer of hope right now is that doctors have started to reduce the number of prescriptions for these things that they write, so that will keep future substance abusers—that will keep the number of future substance abusers down somewhat, but I do fear that we are going to see larger numbers before we start to see smaller ones.
Casey: What else do you sense has happened in the last couple of days since the stories have broken?
Higham: Well, now there obviously is a mad dash to get somebody to run the drug czar’s office, so we’ll see what happens there. But there’s also a lot of pressure now being put on this law that Mr. Marino had introduced, along with a handful of other members of Congress. So, we’ll see what happens with that. The DEA Chief Judge has written 115-page legal analysis of this bill, in which he says this upends 40 years of law, and it really makes it very difficult for the DEA to do its job.
And so, AG Sessions yesterday, along with the Deputy Attorney General said that they were looking at this very seriously. I think there’s a lot of people at the Justice Department, perhaps at the White House legal counsel taking a look at the law, and what it says. If you or I were to read this law, it’s a lot of goobly-gook, but if there’s a—if you’re a drug lawyer, or somebody who is in that world, you know exactly what those words mean, and exactly what those words will do, and I think this is one of the reasons why it kind of slipped through Congress, because a lot of people said, “Well, it’s the insuring patient access and effective drug enforcement act. Why would you be opposed to something like that?”
Well, it does nothing to ensure patient access. It does nothing to improve enforcement of the nation’s drug laws. It actually does the opposite. So, I think that’s probably the next step, is what happens to that law. There have been calls to repeal it, and we’ll have to see what happens.
Bernstein: We just heard in the green room from some of the senators there that the Senate judiciary committee will be holding a hearing soon on the bill. And I would not be surprised if Joe Rannazzisi is their first witness.
Casey: I heard from Scott, as well, that you’ve gotten so many emails, just an overwhelming flood of emails, and a lot of personal accounts. This has happened to my family; thank you for reporting on this. But also, this story gets at the fundamentals of government; a bill—it doesn’t hit my Schoolhouse Rock memory of how a bill becomes a law, where everybody reads it and talks about it and discusses it and changes, it, and then votes on it. So, are you getting feedback from people who are glad that you’re taking the scales from our eyes about how legislation really happens here in Washington?
Bernstein: No, absolutely. We’ve gotten a lot of readers calling and writing, saying thank you very much; you’re holding people accountable. This is exactly what journalists are supposed to do. I’ve gotten notes from people saying, I’ve never written to a reporter in my life. Thank you very much. And I’ve been doing this for a while, so it’s been a really humbling experience, and I think that what we were able to do is pull the curtain back on how Washington really works, and it’s not very pretty.
Lobbyists do right legislation; members of Congress do not pay attention to that legislation; a lot of them take money from special interests without really understanding what is behind that money, or just kind of turning a blind eye to what these corporations really want. But these companies don’t give money to members of Congress for nothing; they usually want something in return, and I think what The Washington Post and 60 Minutes has shown the country is, is that our elected representatives need to pay a little bit more attention to what’s happening in the halls of Congress.
Rosen: We have a comment section on the 60 Minutes webpage, and normally after a story that I’ve done, it’s about 50/50. You guys should be strung up, you totally missed it, you media, you lefties. This is the first time I’ve actually, in reading the comments, it’s almost universal; good for you guys, and congratulations, and do more of it. I’ve never had a story in the years I’ve been there that had been so positive in the comments section, because as you know, the United States is divided. These comments were not divided.
Higham: And I think that goes back to what Libby and Lenny is that this knows no bounds, this epidemic. And so, everybody knows somebody who has been affected. Everybody knows somebody who has died or they know somebody who knows somebody who has died, and these are Republicans, these are Democrats, these are families that have no political bent whatsoever. This is not a political issue, and I think that’s why there’s been such an outpouring of appreciation from all kinds of people because this has nothing to do with politics.
Casey: People on Twitter are generally wondering, are enough people covering the epidemic? Are enough news organizations covering the epidemic, especially from an investigative lens? So, they’re asking, what other angles—where else can this reporting go? So, of course, we don’t expect you guys to divulge exactly what you’re working on.
Rosen: Stay tuned.
Casey: So, what insight can you give us of where this goes?
Bernstein: Well, as everyone knows, regional newspapers have been hit very hard over the past 10, 12 years, and all of them are covering the opioid epidemic, but they don’t have the luxury sometimes of our two news organizations to spend six months on an investigative piece like that. So, we are grateful for that opportunity. I think that some of them are doing a damn good job reflecting what’s going on in their community, and making the people who could change things aware of what’s going on.
Higham: Yeah, The Gazette in West Virginia just won a Pulitzer prize for its coverage of this epidemic, and that’s really inspiring to us. To see these small news organizations that are struggling because they’ve lost so much advertising over the last decade, still putting resources into this story is really important. So, we cheer all those people on.
Casey: Ira, where does this go from here?
Rosen: I think that the story that we did will get local television stations now to say, let’s cover it in our area in a bigger way. Let’s not just cover the car crash or the local three-alarm fire; let’s devote resources to this. And when that happens, here’s how it works in Washington. So, those stories happen, people at home get outraged, they call their senator and congressman, the senator and congressman looks at the mail and the incoming phone lists, and says, “Oh, I better do something about it.”
And so, legislation is then proposed, maybe to remedy it. Law enforcement maybe devotes more resources in a proper way, and then ultimately it goes to the executive branch, that says, “Oh, this is going to be a big voting issues in 2020,” and so then it happens. So, in many ways, it begins with the media coverage, and it’s being recognized now in the local level, probably which is the most important level in media at the moment. And once when that happens, it kind of gets its way—it finds its way to Washington.
Casey: Should we watch out for more collaborations between The Washington Post and 60 Minutes?
Casey: Anything else you want to say about that? The journalist in me is—
Rosen: We won’t be doing the Chicago Cubs.
Casey: Okay. No Nats coverage. Gentlemen, thank you so much for sharing some insights into your reporting. Let me just reminder you, we’ve been talking, of course, with Ira Rosen, producer at 60 Minutes responsible for the story there, and our reporters here at The Washington Post, Scott Higham, and Lenny Bernstein. I’m Libby Casey. Thank you so much to all of you for joining us today, and let me just remind you that you can follow all of our upcoming events at WashingtonPostLive.com. Thank you so much everyone. Thanks.
Leidos Sponsored Segment: ‘A Call to Action’ on the Opioid Crisis:
Brownstein: Good morning, everybody. There he is.
Krone: Thanks, Ron.
Brownstein: Thank you. Roger, let me start by asking you, you’re an engineer by training, not a physician, not an epidemiologist. What motivated you and the company to get involved in this issue?
Krone: Well, you have to understand the company a little bit. So, we’re a 49-year old company and for 42 of our 49 years, we were employee-owned, and so we’ve always had a very active employee population and very vocal. And as CEO, I like to say I’ve got 32,000 bosses. And they’re more than willing to send me an email and to point out issues of the day. And that happens all the time, and oh, gosh, six months or so again, I got a longer than normal email from an employee who works in one of our DOE programs out of Pittsburgh. We have about 330 locations in the U.S.
And I started reading it, and it just really reached out and grabbed my heart. This fellow’s name is John Hinman and he had a son who was an athlete in high school, who’d gotten involved with over the counter drugs, with opioids, and as John relates the story, had been in rehab and had been out. And eventually, having been off of opioids for a while, had a relapse, and because his tolerance for opioids had gone down, he took a lethal dose, and there was no Naloxone or Narcan available, and so he lost his son.
And we do about 25% of our business in healthcare. We have worked with CDC, population health with NIH, and so we have a big presence in the whole healthcare market writ large, and it was sort of a call to action. He said, “Listen, I’m doing all I can—awareness in the Pittsburgh area. What can the company do, and what can you do?” And it just reached out, and I said—I wasn’t all that aware of the pervasiveness of this as an epidemic.
Brownstein: Yeah, so you begin your initiative last spring—this spring. What have you learned over that period about where an employer, where a company can be most useful in helping its employees deal with this?
Krone: Right, well, I was a bit of, you know, an engineer, sort of breaking down what’s going on, and supply-demand and all that, and we kind of put it in three pieces; awareness, prevention, and treatment. And found that from a corporation, frankly, as an individual, we can actually touch all three phases. Awareness, we work with DEA 360 program, public service ads, education at the K through 12 level. And prevention, we actually fund disposable bags; you can go to our website, we make those available to our employees, and anyone who wants to go to our website and ask for one. And actually, we have a mail-order prescription program as part of our medical benefit, and we’ve talked to our provider about cutting down the dosages, and making the drug less available.
And then in prevention, for us, it was to make sure that families of—who have a problem in the family, have access to what is really the antidote, Naloxone or Narcan, and so we have funded dosages of Narcan, the nasal aspect, to anyone who will come and take the training, and we use the Chris Atwood Foundation, but there are other organizations that we’re involved with. We’re able to move quickly, we’re able to amass the resources to try to deal with this at those three levels.
Brownstein: You mentioned 330 locations around the country. Does this problem look significantly different in different places? Are you finding that it is unfolding in different ways?
Krone: You know, it’s really socioeconomically blind. And in fact, what we have found is it still has a stigma. You know, I grew up in the ‘70s, and the idea of morphine-based recreational—that stigma still exists, and way too often, it’s not identified, or it’s not dealt with proactively, but we find in all of our locations, in all socioeconomic classes of our employees, it is a problem, and it’s a problem because I don’t think it’s identified, and I don’t think it’s dealt with in a proactive way.
But we do find really from coast to coast that this—
Brownstein: Really, everywhere? And based on your experience and what you have seen in the reaction from the employees, where—and the kind of learning where—what the levers are that you—where you can make a difference, what would be the principle lessons of your experience you would say to other large employers?
Krone: Well, first of all, it is a problem, and it exists in your population, whether you know about it or not, and unfortunately, it is, again, because of the stigma, it is not brought forth as much as some of the other issues that we have been dealing with in the medical—we do a lot of cancer research and you know, cancer is—okay, this is an epidemic and has a stigma, sort of like, well, you got into it because of recreation. The fact is, most people who have this problem, got to it through a prescription, because of a sports injury or a surgery or something like that.
But what we found is it exists within your population, within the community in which you operate, and there’s a lot that you can do about it. There’s, you know, there’s awareness and funding, and what we like within Leidos, as a company, we can move dollars quickly, and by the way, we’ve found both at the federal, the state, and local level, great partners in government. This is an issue you saw from the prior panel, that touches home for all of our elected officials, and where we have wanted to go out to a community center and put a program in place, we always get strong support from the elected officials in that community.
Brownstein: So, maybe you’ve hinted at the answer already in something you said about kind of the reach of this. But what do you think is, the biggest misconceptions about the way this crisis is unfolding?
Krone: I think the misconception is that the people who have an issue or have an addiction to especially something like oxycodone, or fentanyl, that this was somewhat self-inflicted and brought upon themselves. Or maybe they got to it from a recreational standpoint, and it’s not that at all. I mean, these are people who never intended to get addicted. They might have had a pain problem; they might have had a lower back—it could have been a sports injury. It could have been—in my case, I had a rotator cuff surgery this year. I might still have oxycodone in my medicine cabinet.
And the stigma is, so, let’s not talk about it; let’s not bring it forward; let’s not go get help. We have an employee assistance program at Leidos from an anonymous basis, our employees can go get help. And the stigma is go treat it, go deal with it, get it out in the open, and I’m really pleased in the last six months, the last year, there’s been a lot more discussion, a lot more awareness. There are parents out there who probably don’t even know what the signs look like, because we haven’t been talking about this for very long, and because it starts, often, under a doctor’s care, having to deal with a medical condition.
It’s thought of, well, if I have a prescription for these medicines, then maybe it’s okay. And the answer is, abuse of anything, whether it’s prescription or not prescription, is not okay.
Brownstein: What do you think the hurdle is that’s preventing more employers from—why are we not seeing more large employers make this kind of—
Krone: I think it’s more awareness. Everyone that I talk to—other CEOs here in the national capital region—they’re not aware the depth and breadth of what is truly an epidemic. Two weeks ago, I had a town hall where we talk about financial results and our strategy, and I always take questions at my town hall, and two questions in, someone in the back stood up and said, “I had a son who died of opioid addiction.” Frankly, kind of getting ready for this event, I was going through emails last night, and I learned of a close friend who had a son pass away just recently from an opioid addiction, and I think the issue with other CEOs and other corporations is they don’t know.
Because of PII issues, and because we keep all medical data confidential within the employee—
Krone: Personal information. Personal medical information, the HIPAA laws and things like that, is it’s hard to aggregate the numbers. But we know in 2016, we had more people in the U.S. die of opioid addiction, opioid overdose, than the number of soldiers that we lost in Vietnam, Desert Storm, Desert Shield, and Enduring Freedom combined, in just one year. And I’m sure you’ve seen the statistics in Maryland, which is where I live. We lose more people to opioid addiction in the state of Maryland than car crashes and gun shots, combined.
Brownstein: Let me ask you one last thing. We just had three senators talking about public policy. Obviously, our hosts have had a very explosive expose over the weekend on public policy. Without getting into necessarily those specifics, what do you think the private sector needs in terms of public policy and partnership with government in order to make the maximum impact?
Krone: Well, first of all, I will tell you that we have enjoyed great partnerships with government agencies, again, at the federal, state, and local. We need a good container, and a set of policies that allow us to garner resources so we can address the problem. We need awareness, and to some extent, we need to focus on the issue and maybe not look in the rearview mirror. We are where we are, and it’s about what we’re going to do from today forward, relative to legislation, and dealing with this.
I saw the 60 Minutes piece, and I understand that the facts that were laid out there; it’s sort of like, I’m not sure I care. I care about what we’re going to do tomorrow to address this terrific epidemic here in the U.S.
Brownstein: Thank you. Firstly, you’ve given us a lot to think about, and second, it would not be a panel in Washington if you had not given us an acronym that I did not know, so now we officially have conducted a Washington panel. Thank you. I’m going to turn you back to The Washington Post for the remainder of the program. Thank you.
Krone: Thank you.